Discussion point: what should have been done with Typhoid Mary?

The Daily Mail has published eerie pictures of the abandoned medical facility in North Brother Island, to which Typhoid Mary was exiled by the New York public health authorities.

She meant no harm, certainly had not committed the sort of crimes that usually result in a life sentence, yet she caused several deaths. What should have been done with her?

Mary Mallon ended up causing more deaths by her stubborn refusal to believe that she was a carrier, and her breach of her undertaking to cease working as a cook. What should be done with someone who through no fault of their own carries a dangerous disease and unlike Mallon tries their best to act responsibly – but who nonetheless still causes deaths by their mere proximity to other people? We are horrified at the medieval leper’s bell and the leper colony but our sense of superiority rests on the fact that we now can treat leprosy. New plagues might arise that we cannot treat…

…yet we can be certain the plague of tyrannical abuse of power in the name of health will always be with us.

June 28th, 2013 |

16 comments to Discussion point: what should have been done with Typhoid Mary?

Mary’s was not a situation with a ‘good’ solution, but ‘honorable confinement’ strikes me as being at least reasonable. What was the alternative, letting her go about infecting others with a sometimes fatal disease? Sickness and death impact liberty, too.

Let me argue the case by analogy. Consider some old codger whose eyes had given out, gets in a car and kills someone in an accident. The accident was due to the fact that he can’t see the steering wheel, never mind the car in front.

Grandpa’s blindness was not his fault, just a result of nature, nonetheless, he is culpable for his actions, because he did something that caused the death of another due to his own recklessness.

There is even a case for prior restraint — we can legitimately arrest grandpa for just getting in his car when he is evidently incapable of operating it safely with regards to other road users.

Mary, by simply going out in public is behaving in a reckless manner. Depending on your degree of libertarianism you can either charge her with manslaughter by gross negligence after somebody dies, or use prior restraint to prevent the inevitable.

Of course, I am assuming she has been diagnosed as a carrier and has been fully informed, ever if she ignores the information. Grandpa can’t justify his actions either by saying that the optician is full of shit.

It’s informative to read the Wikipedia entry on Typhoid Mary. It seems pretty clear that she ignored evidence that her actions were harming and killing people, and she persisted in those actions when she had every reason to believe they would cause further harm. She also refused to cooperate with attempts to reduce that harm (by helping to identify other people who might have been infected by her).

The only thing that complicates the question of her culpability at all is her claim that she did not believe she carried the disease. That doesn’t seem like a very strong defense, to me. In the first place, we can’t know if she truly did believe she didn’t carry the disease, or whether she just used that as a defense. But even if she did truly believe that she carried the disease, wouldn’t a reasonable person act with caution, given the stakes and the (always present) possibility of being wrong? It doesn’t seem to me that her actions meet the “reasonable person” standard, and so she should be held legally culpable.

But then I’m looking at if from the perspective of 2013, where viruses and bacteria are commonly understood. The standard of reasonableness might have been a bit different a century ago.

I’m not appalled by leper colonies at all. I wouldn’t have wanted to live in one, but I’d have wanted to live in a society where everyone’s limbs started falling off even less. Quarantine, even forcible quarantine, is a perfectly reasonable response to ugly diseases. Sucks for the people involved, but at some point you have to go utilitarian on these sorts of problems. This is the same reason I favour mandatory(or at least extremely difficult to opt out of) vaccination.

Tedd, she comes across as an uneducated and, which is not the same thing, a stupid woman. By the time of her second quarantine in 1915 the general public of a developed nation would have understood infectiousness – probably better than the pampered public of our own time who have forgotten what epidemics are like. As the saying goes, there’s none so blind as those that will not see.

In her defence, as Upton Sinclair said, “It is difficult to get a man to understand something, when his salary depends on his not understanding it.” More than just her wages, too. How horrible to think that she had already killed several people she knew. Perhaps that is why she resisted accepting it so strongly.

BUFFALO (AP) — The state can try to keep a sex offender who infected at least 13 women with the virus that causes AIDS locked up beyond the 12-year prison sentence he completed in April, a judge ruled on Monday
….
In court documents, the attorney general’s office described Mr. Williams as a mentally disturbed, sex-obsessed drug user who was cited for 21 disciplinary offenses in prison.

The accidental infection of someone else leaves someone open to civil suite – but bankruptcy most likely would not have scared Mary M. (being poor to start with).

However, to continue to infect people AFTER you have been told you are a carrier and that if you carry cooking for people you will kill them, leaves someone open to the charge of murder. And “I just do not believe you” is not a good defence (anyone can say that “I just do not believe that shoving this knife into someone, repeatedly, will do them any harm – just because it killed the last the few people I shoved the knife into, does not mean it will kill this one”).

In short Mary M. could have faced the rope. I hope what the lady actually faced was not too terrible.

Koch’s postulates were formulated and well-known in the last decade of the 19th Century, germs as causes of disease was clinically established by 1915. She changed her name, i.e. she used deceit, to carry on working as a cook. I would suggest that she had a duty of candour in respect of her condition, viewed objectively, and she was a public nuisance.

In her lifetime, there were no known antibiotic treatments for her condition. Not likely to be murder Paul, manslaughter, she may have lacked intent to cause death or serious bodily harm, or she may have been stupid and bloody-minded and plain indifferent to the suffering of others, like a typical NHS nurse in Mid-Staffs, one might think.

Possible alternatives to incarceration?

Deportation, she was born in (what is now Northern) Ireland.

Branding/Tattooing, with a ‘T’ on her forehead, so no employer could be deceived.

An infantile absolutism leading one to react against measures such as quarantine that makes libertarians targets of ridicule and scorn. I would hope that a jury would have to approve such measures on conviction for a specific offence.

I strongly suspect that in a stateless, private law society, someone, possibly a victim’s relative, possibly not, would just have killed her.
When people heard about it, the majority would just lift their eyebrows and shrug their shoulders. Maybe some would nod.
Not to say that any of this is right, or moral, but… bad things happen. This was a situation where bad things were going to happen regardless and the only choices were which bad things happened to which people.
If it was clear Mary wasn’t going to volunteer to go into exile someone would have made the choice that bad things were going to happen to her rather than them and theirs.

I strongly suspect that in a stateless, private law society, someone, possibly a victim’s relative, possibly not, would just have killed her.

I disagree. In a private law society, by which I presume you mean one where contracts are submitted to consensually entered binding arbitration bodies, her employment contract would have been enforced. The majority of employment contracts for cooks would have included (and probably still do) a “no known risks” or some other clause intended to identify people knowingly unfit to do the job safely. Had she committed fraud on her application, the contract’s terms would apply. Quite possibly, in the case of contractees without forfeitable assets, there would have been incarceration in lieu of damages terms in order to make it a meaningful contract.

Just as employers can name in the contract an amount they will pay out in the event of work related injuries or death, employees can name a penalty they will face for defrauding their employer. In this case, defrauding multiple employers of the lives of their family members could carry a very high cash or time-incarcerated penalty.

Re, a private enterprise solution- an Institute could ‘hire’ Mary, at a high salary, to be a testee of germs. They could look into why she didn’t have symptoms, and they might find a cure for her- and for all people!

In Mary’s time, the idea that you could carry a disease even though you’d never had it yourself was new, and suspect among many people — especially in the poorly educated, lower-working-class, which, as a poor immigrant from Ireland, I suppose Mary was. Also, there was discrimination against the Irish, and I suppose a fairly widespread mistrust of The Authorities and their Pronouncements. We Educated Fools have the same mistrust even today, do we not? Do you believe everything the Health Authorities (in the U.S., say, the Surgeon General) tell you? If in some instance it turns out that they’re right and you’re wrong and somebody dies because of it, are you morally culpable?

Also, there’s a good deal of “settled science” that ain’t so even in our own day, after all. I fight to the death with people who think that McBurgers are bad for you–they’re not, they’re a very small steak with a tiny salad and a couple of teaspoons of dressing in a bun. Big deal.

Since the Sixties we’ve been threatened with heart attack if we walked past the whole-milk section of the dairy case. Then it was eggs. Then shrimp!!!. Butter EVIL, eat OLEO!!! (Even I knew that was tripe. Oleo. What do they think hydrogenation does!) Nowadays they’re saying maybe butter is better — if you MUST eat fat. (Clue: You must.) I don’t believe a word out their mouths, frankly.

There’s a fine art to knowing when to obey the Doctor’s Orders and when to do the exact opposite. In my experience few of them are really interested in your story — when they want to know it, they’ll tell you what it is. (There are good docs too–don’t misunderstand me.)

Then there’s warble gloaming….

Also, someone pointed out that this was perhaps the very first instance of a carrier who did not have, and never had had, the disease he or she passed on to others.

There’s a book on this by a U of Wisc. professor of medical history, Judith Walzer Leavitt, entitled Typhoid Mary: Captive to the Public’s Health. The Amazon reviews make some interesting points. See

Now it was wrong of Mary to change her name and go back to cooking after promising she wouldn’t, and would work as a laundress instead. But from her point of view, believing as she did, “where’s the harm?”

I think that she’s technically guilty but probably not morally culpable, at least up to that point — and even there, her moral wrongdoing was in going back on her word — assuming she had done her best to assess the evidence, such as it was; and we have no reason to assume she hadn’t. Innocent until proven guilty, all that.

By the way — there may have been some question about the case, because when she died they did an autopsy and did find the typhoid bacillus in her pancreas. The theory is that her mother had the disease, or at least exposure to it, during her pregnancy, and Mary acquired immunity in the womb.

If we want to talk about people who “should have known better” and therefore have blood on their hands, let’s discuss the Educated Classes who decided the USSR was just great, and the “anti-war” (in a pig’s eye they were/are!) activists like Ms. Fonda & Mr. Chumpsky & Co. who had degrees up the wazoo and swore Ho & Co. wouldn’t hurt a flea. And today’s fools who think we should just let Radical Jihad run all over us. What price education!

Tedd, she comes across as an uneducated and, which is not the same thing, a stupid woman. By the time of her second quarantine in 1915 the general public of a developed nation would have understood infectiousness – probably better than the pampered public of our own time who have forgotten what epidemics are like. As the saying goes, there’s none so blind as those that will not see.

Mary was at the top of the social food chain for the servant class in her day, and asking her to refrain from employment as a hired cook was asking her to give up life as she knew it. I think this is as much a case of her grasping at every straw in an effort to not believe than it is a case of her being stupid.

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